Bostan Ozge Can, Akcan Beyza, Saydam Cihan Durmus, Tekin Muhammet, Dascı Omur, Balcan Baran
Department of Allergy and Immunology, Hacettepe University School of Medicine, Ankara, Turkey.
Department of Pulmonary Medicine, Marmara University School of Medicine, Istanbul, Turkey.
Eurasian J Med. 2021 Feb;53(1):34-39. doi: 10.5152/eurasianjmed.2021.19233.
Obstructive sleep apnea (OSA) is more common in men than in women. In this study, we aimed to address the impact of gender on symptoms and comorbidities in patients with OSA.
This cross-sectional study was conducted among 1,317 consecutive patients, who were admitted to the Sleep Apnea Clinic of the Marmara University Hospital between November 2015 and October 2018, and who completed questionnaires and a sleep study with cardiorespiratory polygraphy. OSA was defined as Apnea Hypopnea Index (AHI) ≥15/hour.
In all, 1,042 patients (334 women) fulfilled the inclusion criteria. OSA was observed in 589 patients (56.5%). Women were older than men (50.2±12.5 versus 45.6±15.1 years) and had lower AHI (22.1±20.1 versus 26.8±21.9 events/h). In the OSA group, women were older (53.7±11.5 versus 47.8±12.8 years) and more obese (BMI 34.6 versus 31.8 kg/m). Symptoms were categorized as frequent/very frequent, and women with OSA complained more about daytime fatigue (74.6% versus 63.7%), nocturia (69.7% versus 51.8%), headache in the morning (50.0% versus 28.4%), depressive mood (49.0% versus 19.5%), and restless legs symptoms (43.1% versus 17.2%), than did men (all p values <0.05). Comorbidities were observed more in women than in men (lung disease [25.4% versus 13.7%], hypertension [29.6% versus 15.0%], diabetes [20.3% versus 11.3%], and hypothyroidism [14.0 % versus 4.1%]). In regression analysis, age (OR 1.03, p<0.001), BMI (OR 1.13, p<0.001), and male sex (OR 2.08, p<0.001) were significantly predictive for OSA while history of tonsillectomy was protective (OR 0.48, p=0.033).
Fatigue, nocturia, headache, depressive mood, restless leg, and comorbidities were observed more in women. OSA-related symptoms develop late and/or the referral of women for diagnostic evaluation of OSA is delayed. Symptoms and comorbidities in women should be evaluated more attentively for earlier referral and diagnosis of OSA.
阻塞性睡眠呼吸暂停（OSA）在男性中比在女性中更为常见。在本研究中，我们旨在探讨性别对OSA患者症状和合并症的影响。
本横断面研究纳入了1317例连续患者，这些患者于2015年11月至2018年10月期间入住马尔马拉大学医院睡眠呼吸暂停诊所，并完成了问卷调查以及心肺多导睡眠监测。OSA定义为呼吸暂停低通气指数（AHI）≥15次/小时。
共有1042例患者（334例女性）符合纳入标准。589例患者（56.5%）被观察到患有OSA。女性比男性年龄更大（50.2±12.5岁对45.6±15.1岁），且AHI更低（22.1±20.1次/小时对26.8±21.9次/小时）。在OSA组中，女性年龄更大（53.7±11.5岁对47.8±12.8岁）且更肥胖（BMI为34.6对31.8kg/m²）。症状被分类为频繁/非常频繁，与男性相比，OSA女性患者更多抱怨白天疲劳（74.6%对63.7%）、夜尿症（69.7%对51.8%）、晨起头痛（50.0%对28.4%）、抑郁情绪（49.0%对19.5%）以及不安腿症状（43.1%对17.2%）（所有p值<0.05）。女性比男性观察到更多的合并症（肺部疾病[25.4%对13.7%]、高血压[29.6%对15.0%]、糖尿病[20.3%对11.3%]以及甲状腺功能减退[14.0%对4.1%]）。在回归分析中，年龄（OR 1.03，p<0.001）、BMI（OR 1.13，p<0.001）以及男性性别（OR 2.08，p<0.001）对OSA有显著预测作用，而扁桃体切除术史具有保护作用（OR 0.48，p = 0.033）。
女性中疲劳、夜尿症、头痛、抑郁情绪、不安腿以及合并症更为常见。与OSA相关的症状出现较晚和/或女性进行OSA诊断评估的转诊延迟。应更仔细地评估女性的症状和合并症，以便更早地转诊和诊断OSA。
